FIR2022-0061_Applicant_Response_6.10.2022_10.00.39_AM_2924704BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: htt ): ww�y.edmond.svm.R: '
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job site Address: 777 Maple St Edmonds, WA 98020
Parcel: 00434208902300
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Peggy Weirauch
Mailing Address: 777 Maple St
City/State/Zip: Edmonds, WA 98020
Phone 4: 206-334-5213
Email. Peggy@weirauch@icloud.com
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? ❑ Yes X No
I own, reside in, or will reside in the completed structure.
This installation is being made on property that I own which is
not intended for safe, lease, rent, or exchange according to
RCW 18.27.090.
Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Melinda Hess
Mailing Address: PO Box 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: info@filcoenviro.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Fllco Company, Inc.
Mailing Address: PO BOX 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: infoCabfilcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
FILCOCIO80RU 12/31/2022
CITY OF EDMONDS BUSINESS LICENSE #: NR-024111
Permit #:
TYPE OF PERMIT
. Details
❑ Accessory Structure/
Detached Garage
❑ Addition
❑ Demolition
((Mechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Remodel
❑ Re -Roof
❑ Fire Sprinkler
❑ New Commercial/ Mixed Use
❑ Signs
❑ Tank
❑ Tenant Improvement
❑ Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value hounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work Indicated on this application.
Valuation:
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sgft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
PROJECT DESCRIPTION
Pump out triple rinse and fill with Foam one
550 gallon underground heating oil tank.
I certify that the information I have provided on this farm/application Is true,
correct and complete, and that I am the property owner or duly authorized
agent of the property owner to submit a permit application to the City of
Edmonds.
I
Print Name: Melinda Hess
Signature: ied6/10/202�
GFNERAL COMMERCIAL DATA
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes ❑ No ❑
WA STATE ENERGY CODE: If your project affects the building envelope,
mechanical systems, and/or lighting, you must complete the
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial building permits that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
permits are applied for separately.
TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT Worksheet
MECHANICAL EQUIPMENT COUNTS (New and Rc-lcicitvcl)
BTUs Gas / Elec / Other City
A/C Unit /Compressor
Air Handier/VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronlc Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
PLUMBING FIXTURE COUNTS (New, Relocated or re -piped)
Qty City
Clothes Washer
Tub/Showers
Dishwasher
Backfiow Device (RPBA, DCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
Floor Drain/Sink
Refrigerator Water Supply
Hose Bibs
Water Heater-Tankless? Y or N
Hydronic Heat
Water Service Line
Sinks
Other:
Other:
Toilets
GAS/FUEL CONNECTION COUNTS (New, Relnc..rted or re -piped)
l BTUs Qty BTUs City
A/C Unit
Outdoor BBQ/ Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace
MEDICAL
(New,
Other:
GAS, AIR VACUUM COUNT�
Rplocated or re-pipud)
City city
Carbon Dioxide Nitrous Oxide
Helium Oxygen
Medical Air Other:
Medical - Surgical Vacuum I I Other:
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Survey done? Y / N PSCAA Case q:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
FIII In Placed FIII Material: Foam
Removal ❑ I Size of Tank (Gallons) 55U
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
Grading: Cut cubic yards
Fill __ cubic yards
Cut / FIII in Critical Area: Yes ❑ No ❑
APPLICATIONS: Applications are valid for a maximum of 1 year.
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & Industries and have a
current City of Edmonds Business License,